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Surgeon-tailored polypropylene mesh as a needleless single-incision sling versus TVT-O for the treatment of female stress urinary incontinence: a comparative study.
Int Urol Nephrol. 2015 Jun; 47(6):937-44.IU

Abstract

PURPOSE

To compare safety and efficacy of surgeon-tailored polypropylene mesh through needleless single-incision technique (STM) versus tension-free vaginal tape-obturator (TVT-O) aiming to decrease cost of treatment of stress urinary incontinence (SUI). This is important in developing countries due to limited healthcare resources.

PATIENTS AND METHODS

A retrospective cohort study was done at Urology and Gynecology Departments (dual-center), Cairo University, from January 2011 to August 2013. STM was inserted in 72 females, while TVT-O was inserted in 48 females. Females evaluated by cough stress test, stress and urge incontinence quality of life questionnaire (SUIQQ), Q max and abdominal leak point pressure (ALPP) were included. Different factors were compared between both groups using paired t, Wilcoxon's signed rank, McNemar, Chi-square, Fisher's exact, independent t or Mann-Whitney tests.

RESULTS

Age, parity, previous surgeries, ALPP, intrinsic sphincter deficiency (ISD), associated prolapse and associated prolapse repair were comparable in both groups. No significant difference was found between both groups in postoperative complications (except groin pain), cure, SUIQQ indices improvement and Q max decline. In total, 65 (90 %) cured, 6 (8 %) improved while failure was detected in one (1 %) patient in STM group, while 42 (87 %) cured, 4 (8 %) improved and failure was detected in two (4 %) patients in TVT-O group. Presence of ISD (p = 0.565), urgency (p = 0.496), UUI (p = 0.531), previous surgeries (p = 0.345), associated urogenital prolapse (p = 0.218) or associated prolapse repair (p = 0.592) did not lead to any significant difference in outcome between both groups. Cost of mesh decreased from US$500 (TVT-O) to US$10 (STM).

CONCLUSION

Outcome of STM is comparable to TVT-O. Furthermore, STM is more economic.

Authors+Show Affiliations

Urology Department, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt, mohammedshemy@yahoo.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Study
Comparative Study
Journal Article

Language

eng

PubMed ID

25899765

Citation

ElSheemy, Mohammed S., et al. "Surgeon-tailored Polypropylene Mesh as a Needleless Single-incision Sling Versus TVT-O for the Treatment of Female Stress Urinary Incontinence: a Comparative Study." International Urology and Nephrology, vol. 47, no. 6, 2015, pp. 937-44.
ElSheemy MS, Fathy H, Hussein HA, et al. Surgeon-tailored polypropylene mesh as a needleless single-incision sling versus TVT-O for the treatment of female stress urinary incontinence: a comparative study. Int Urol Nephrol. 2015;47(6):937-44.
ElSheemy, M. S., Fathy, H., Hussein, H. A., Hussein, E. A., & Hassan, S. M. (2015). Surgeon-tailored polypropylene mesh as a needleless single-incision sling versus TVT-O for the treatment of female stress urinary incontinence: a comparative study. International Urology and Nephrology, 47(6), 937-44. https://doi.org/10.1007/s11255-015-0974-4
ElSheemy MS, et al. Surgeon-tailored Polypropylene Mesh as a Needleless Single-incision Sling Versus TVT-O for the Treatment of Female Stress Urinary Incontinence: a Comparative Study. Int Urol Nephrol. 2015;47(6):937-44. PubMed PMID: 25899765.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgeon-tailored polypropylene mesh as a needleless single-incision sling versus TVT-O for the treatment of female stress urinary incontinence: a comparative study. AU - ElSheemy,Mohammed S, AU - Fathy,Hesham, AU - Hussein,Hussein A, AU - Hussein,Eman A, AU - Hassan,Sarah Mohamed, Y1 - 2015/04/22/ PY - 2015/02/05/received PY - 2015/04/03/accepted PY - 2015/4/23/entrez PY - 2015/4/23/pubmed PY - 2016/2/26/medline SP - 937 EP - 44 JF - International urology and nephrology JO - Int Urol Nephrol VL - 47 IS - 6 N2 - PURPOSE: To compare safety and efficacy of surgeon-tailored polypropylene mesh through needleless single-incision technique (STM) versus tension-free vaginal tape-obturator (TVT-O) aiming to decrease cost of treatment of stress urinary incontinence (SUI). This is important in developing countries due to limited healthcare resources. PATIENTS AND METHODS: A retrospective cohort study was done at Urology and Gynecology Departments (dual-center), Cairo University, from January 2011 to August 2013. STM was inserted in 72 females, while TVT-O was inserted in 48 females. Females evaluated by cough stress test, stress and urge incontinence quality of life questionnaire (SUIQQ), Q max and abdominal leak point pressure (ALPP) were included. Different factors were compared between both groups using paired t, Wilcoxon's signed rank, McNemar, Chi-square, Fisher's exact, independent t or Mann-Whitney tests. RESULTS: Age, parity, previous surgeries, ALPP, intrinsic sphincter deficiency (ISD), associated prolapse and associated prolapse repair were comparable in both groups. No significant difference was found between both groups in postoperative complications (except groin pain), cure, SUIQQ indices improvement and Q max decline. In total, 65 (90 %) cured, 6 (8 %) improved while failure was detected in one (1 %) patient in STM group, while 42 (87 %) cured, 4 (8 %) improved and failure was detected in two (4 %) patients in TVT-O group. Presence of ISD (p = 0.565), urgency (p = 0.496), UUI (p = 0.531), previous surgeries (p = 0.345), associated urogenital prolapse (p = 0.218) or associated prolapse repair (p = 0.592) did not lead to any significant difference in outcome between both groups. Cost of mesh decreased from US$500 (TVT-O) to US$10 (STM). CONCLUSION: Outcome of STM is comparable to TVT-O. Furthermore, STM is more economic. SN - 1573-2584 UR - https://www.unboundmedicine.com/medline/citation/25899765/Surgeon_tailored_polypropylene_mesh_as_a_needleless_single_incision_sling_versus_TVT_O_for_the_treatment_of_female_stress_urinary_incontinence:_a_comparative_study_ L2 - https://doi.org/10.1007/s11255-015-0974-4 DB - PRIME DP - Unbound Medicine ER -